Yann Nguyen1,2, Johanna Sigaux3,4, Jean-Guillaume Letarouilly5, Pauline Sanchez6, Sébastien Czernichow7,8, René-Marc Flipo5, Martin Soubrier9, Luca Semerano3,4, Raphaèle Seror10,11, Jérémie Sellam12, Claire Daïen6. 1. Service de Médecine Interne, Assistance Publique-Hôpitaux de Paris (AP-HP), Nord, Hôpital Beaujon, Université de Paris, F-92100 Clichy, France. 2. Centre de Recherche en Epidémiologie et Santé des Populations, INSERM U1018, Université Paris-Saclay, F-94800 Villejuif, France. 3. Service de Rhumatologie, AP-HP, Hôpital Avicenne, F-93017 Bobigny, France. 4. INSERM U1125, Sorbonne Paris Cité, Université Paris 13, F-93017 Bobigny, France. 5. Service de Rhumatologie, Université de Lille, CHU Lille, F-59000 Lille, France. 6. Service de Rhumatologie, CHU de Montpellier, Université de Montpellier, F-34000 Montpellier, France. 7. Service de Nutrition, Centre Spécialisé Obésité, AP-HP, Hôpital Européen Georges Pompidou, Université de Paris, F-75015 Paris, France. 8. Epidemiology and Biostatistics Sorbonne Paris City Center (CRESS), UMR1153, Institut National de la Santé et de la Recherche Médicale, F-75004 Paris, France. 9. Service de Rhumatologie, CHU Gabriel-Montpied, F-63000 Clermont-Ferrand, France. 10. Service de Rhumatologie, AP-HP, Hôpitaux Universitaires Paris-Saclay-Hôpital Bicêtre, F-94270 Le Kremlin Bicêtre, France. 11. INSERM U1184, Université Paris-Saclay, F-94270 Le Kremlin Bicêtre, France. 12. Service de Rhumatologie, Sorbonne Université, AP-HP, Hôpital Saint-Antoine, Inserm UMRS_938, FHU PaCeMM, F-75012 Paris, France.
Abstract
BACKGROUND: We aimed to provide a systematic review and meta-analysis of randomized controlled trials assessing the effect of oral vitamin supplementation on symptoms and disease activity in patients with rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA). METHODS: A systematic literature review and meta-analysis of randomized controlled trials including patients with inflammatory rheumatic diseases were performed using MEDLINE, EMBASE and abstracts from recent international rheumatology congresses. Studies were reviewed in accordance with PRISMA guidelines. We analysed clinical outcomes according to each type of vitamin supplementation. RESULTS: The initial search yielded 606 articles. Of these, 13 studies were included in the qualitative synthesis: eight studied vitamin D supplementation, two assessed vitamin E supplementation, two folic acid, and one vitamin K, all of them on RA patients. No studies on SpA or PsA were selected. Oral vitamin supplementations were not associated with a reduction in RA activity (DAS-28 or pain) or RA flares. CONCLUSIONS: Despite their beneficial effects, the effects of vitamin supplementation on RA activity, if any, seem to be limited. Evidence on their efficacy on SpA or PsA activity is lacking. However, folic acid supplementation should be suggested to prevent methotrexate-related side effects, and vitamin D should be given to patients with vitamin D deficiency to prevent musculo-skeletal complications.
BACKGROUND: We aimed to provide a systematic review and meta-analysis of randomized controlled trials assessing the effect of oral vitamin supplementation on symptoms and disease activity in patients with rheumatoid arthritis (RA), spondyloarthritis (SpA) and psoriatic arthritis (PsA). METHODS: A systematic literature review and meta-analysis of randomized controlled trials including patients with inflammatory rheumatic diseases were performed using MEDLINE, EMBASE and abstracts from recent international rheumatology congresses. Studies were reviewed in accordance with PRISMA guidelines. We analysed clinical outcomes according to each type of vitamin supplementation. RESULTS: The initial search yielded 606 articles. Of these, 13 studies were included in the qualitative synthesis: eight studied vitamin D supplementation, two assessed vitamin E supplementation, two folic acid, and one vitamin K, all of them on RApatients. No studies on SpA or PsA were selected. Oral vitamin supplementations were not associated with a reduction in RA activity (DAS-28 or pain) or RA flares. CONCLUSIONS: Despite their beneficial effects, the effects of vitamin supplementation on RA activity, if any, seem to be limited. Evidence on their efficacy on SpA or PsA activity is lacking. However, folic acid supplementation should be suggested to prevent methotrexate-related side effects, and vitamin D should be given to patients with vitamin D deficiency to prevent musculo-skeletal complications.
Authors: Cristiano Pagnini; Andrea Picchianti-Diamanti; Vincenzo Bruzzese; Roberto Lorenzetti; Michele Maria Luchetti; Louis Severino Martin Martin; Roberta Pica; Palma Scolieri; Maria Lia Scribano; Costantino Zampaletta; Maria Sole Chimenti; Bruno Lagana Journal: Int J Mol Sci Date: 2021-02-28 Impact factor: 5.923